Esophageal biopsy does not predict clinical outcome after percutaneous endoscopic gastrostomy in children. Dysphagia 2000;15(3):167-9
Date
06/06/2000Pubmed ID
10839831DOI
10.1007/s004550010020Scopus ID
2-s2.0-0034053722 (requires institutional sign-in at Scopus site) 9 CitationsAbstract
Clinically symptomatic gastroesophageal reflux may occur after percutaneous endoscopic gastrostomy (PEG). Preoperative evaluation for gastroesophageal reflux does not reliably predict those individuals who will develop reflux unresponsive to medical management after PEG. Esophageal histology at the time of PEG might be used to identify patients at risk for developing intractable gastroesophageal reflux. The study aim was to correlate the clinical outcome after PEG with esophageal histology at the time of PEG insertion. A retrospective review of 68 consecutive children who had an esophageal biopsy obtained at the time of PEG insertion was undertaken. Preoperative evaluation, esophageal histology, and clinical outcomes were compared. Preoperative gastroesophageal reflux was present in 23% of upper gastrointestinal series performed, in 10% of pH probe studies, and in 29% of reflux scans. Histology was normal in 57% of esophageal biopsies obtained at the time of PEG insertion. Symptomatic gastroesophageal reflux requiring antireflux surgery or conversion to gastrojejunostomy developed in 10% of patients after PEG placement. Only one of these patients had esophagitis on biopsy. In conclusion, preoperative esophageal histology does not reliably predict the development of symptomatic gastroesophageal reflux after PEG placement.
Author List
Heikenen JB, Werlin SLAuthor
Steven L. Werlin MD Emeritus Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Biopsy
Child
Child, Preschool
Esophagus
Follow-Up Studies
Gastroesophageal Reflux
Gastroscopy
Gastrostomy
Humans
Infant
Preoperative Care
Retrospective Studies
Severity of Illness Index
Skin
